Editorial: Fix WA Cares and let it resume its important work

The long-term care program needs modest changes to fairly provide a valuable benefit to seniors.

By The Herald Editorial Board

That state lawmakers are working to delay the state’s long-term care benefit program and address unforeseen complications with the original legislation shouldn’t be viewed as a fatal flaw or a denial of the basic need that WA Cares seeks to address.

Made state law in 2019, WA Cares was intended as a modest payroll tax; 58 cents for every $100 of gross pay for workers in Washington state, or about $5.58 a week for someone making $50,000 a year. Those funds were to go into a special account, invested by the state treasurer, that is intended to pay those participating up to $36,500 — in essence, $100 a day for a year — for their expenses for long-term care for seniors and those with disabilities. Those funds would be available to those who have worked at least 10 years without a break of more than five years; or three of the last six years; and have worked at least 500 hours each year.

WA Cares is the first such program of its kind in the nation to address an increasing problem, a growing population or retirees who aren’t fully prepared to pay for the daily care and assistance with basic needs they are likely to need later in their lives.

The median retirement savings for seniors is about $136,000, but those over the age of 65 can expect average costs of $260,000 over the course of their lives for medical and care services. Very few people carry insurance to provide that care.

“If you’re lucky enough to reach age 65, you’ve got a 7 in 10 chance of needing long-term care, and about 75 percent of people think Medicare covers it, and they’re wrong; people do not have even $35,000 in the bank to cover the costs,” said Dan Murphy, who recently retired as executive director of the Northwest Regional Council Area Agency on Aging, in an interview last week.

“Every day thousands of people come to the realization that they need this care but can’t afford it,” Murphy said.

WA Cares, said Murphy, who assisted in drafting the original legislation, sought to find the balance between a modest and reasonable payroll deduction and a benefit that will provide a helpful supplement. That $36,500 — $100 a day for a year — is enough to provide about 20 hours a week of in-home care.

Murphy admits that the long-term care act wasn’t fully ready when passed; not every potential situation was foreseen. So state lawmakers have gone back and are considering two bills that will delay implementation and make necessary fixes.

House Bill 1732 would delay the collection of the payroll tax until July 1, 2023 and the start of its benefits’ availability until July 1, 2026. It also would allow those born before 1968, who don’t meet the current 10-year vesting period, to receive partial benefits based on years worked before retirement.

House Bill 1733 allows for exemption from the payroll deductions for those who already receive a similar benefit or wouldn’t qualify for it, including veterans eligible for Veterans Administration disability benefits; the spouses of military service members, temporary workers with nonimmigrant visas and those working in the state who are not state residents.

The delay isn’t ideal, but it’s “worth taking the extra time to make these tweaks,” Murphy said.

And there are likely to be “tweaks” to come in the future, said Madeleine Foutch, legislative director for the Service Employees International Union 775, which represents about 45,000 long-term care workers in the state.

The Legislature at some point will need to address how to allow those who have opted out of WA Cares by obtaining private long-term care insurance to opt back in if they lose or drop their coverage. Before last year’s deadline, about 400,000 of about 3.6 million total workers in the state qualified for an exemption from the payroll tax because they had obtained private insurance.

Although not an immediate concern, lawmakers also will need to consider the sustainability of the WA Cares program to ensure it has the funding to avoid reducing the benefit or increasing the payroll deduction in future years. Currently, the fund can only be invested in government bonds and similar investments with safe but relatively low returns. But past constitutional amendments have allowed for the state’s public employees pension fund, its workers’ compensation fund and others to be managed by the state investment board in stocks, bonds and other funds that can provide better returns on investment.

What should not be on the table — this year or in future years — is elimination of WA Cares.

Although not likely to pass either chamber or be signed by the governor, Republican lawmakers have proposed repeal of WA Cares, citing criticisms that the lifetime benefit of $36,500 is inadequate to meet needs; that the current investments won’t be able to sustain the program; and that the issue of long-term care is now better understood by the public and more are now insured.

None of those criticisms, however, are strong enough to warrant repeal. The benefit, which will be adjusted for inflation, isn’t meant to provide all that is needed, but will make a substantial difference for individuals and families. As well, the Legislature has time to address the fund’s investments. And, while more have enrolled in private long-term insurance, such private insurance remains difficult to obtain and too costly for many.

Along with the assistance provided to individuals, WA Cares also should deliver considerable savings to the state and its taxpayers. Analysis estimates that WA Cares will reduce annual Medicaid spending for the state and federal government by $70 million in its first year, by $140 million annually by 2035 and by $410 million by 2050. Over the next 75 years, the total reduction in Medicaid spending is estimated at $18 billion.

With the changes outlined, WA Cares should be allowed to resume as intended.

“We know that if we don’t take any action,” said Foutch, “we will continue to see the inequitable system that exists of family members providing unpaid care, people having to spend down into poverty to access Medicaid, and our seniors and people with disabilities who require care impoverishing themselves to be able to live in their homes with dignity.”

Dr. Charles Mayer, a family physician in Seattle, agreed, pointing to WA Cares’ potential to result in better health for all.

“I see it all, cradle to grave,” Mayer said. “I have plenty of patients who have to deal with not having enough resources at the end of their lives and I see the ethical dilemmas that their children face when they don’t have the resources … when they have to figure out care for their parents.”

Comparing the United States with other countries that have these types of programs, Mayer said, people simply are healthier and live longer.

“This law is all about health,” Mayer said. “Protecting those who are marginalized will improve their health and we’ve got good evidence that this will help.”

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